Medical History Statement Requirement
Electing some levels of life insurance and/or supplemental disability insurance require a Medical History Statement to be submitted to the Standard Insurance Company for approval before your elected insurance can take effect.
For insurance coverage elected during Open Enrollment, the Medical History Statement is due by March 1, 2021.
If you do not submit a completed Medical History Statement to the Standard Insurance Company by March 1, 2021, your elected insurance coverage will be canceled. You will not be able to re-elect coverage until the next Open Enrollment, October 2021, for coverage effective January 2022, unless you have a qualifying life event.
Download and print the MHS here. Then mail to:
Standard Insurance Company
Group Medical Underwriting
900 SW 5th Ave.
Portland, OR 97204
Questions?
If you have questions about the Medical History Statement, or wish to inquire about the status of your submitted statement, you may contact the Standard Insurance Company at 844-505-6025.
If you have general questions about your LAwell benefits, you may contact the LAwell Benefits Service Center at
833-4LA-WELL (833-452-9355).